Friday, September 22, 2023

Chronic Ear Infections In Adults

Chronic Otitis Media Treatments

Chronic Ear Infections

The main form of treatment for chronic otitis media is antibiotics. Antibiotic ear drops are usually prescribed, although some patients may be given a regimen of oral antibiotics. In more advanced cases, surgery may be recommended to:

  • Repair a damaged eardrum and/or hearing bones
  • Remove diseased tissue
  • Insert a small tube into the ear to improve ventilation and drainage

The otolaryngologists, surgeons, nurses and other experts at Tampa General Hospitals ENT & Urology Institute provide well-rounded care to patients with chronic otitis media and other complex ENT conditions.

What Is A Chronic Ear Infection

A chronic ear infection can be caused by an acute ear infection that does not completely go away or repeat ear infections. Acute otitis media is one of the most common types of ear infections. It can become chronic. Otitis media with effusion , which typically occurs in children, can also become chronic.

Otitis media with effusion can occur after an infection has cleared up but fluid remains trapped in the middle ear. When it becomes chronic, it is referred to as chronic chronic otitis media with effusion .

Acute otitis media can also lead to chronic suppurative otitis media , in which ear discharge does not go away or it keeps coming back. CSOM is considered a complication of a middle ear infection. The discharge in CSOM continues to leak out through a hole in the eardrum.

From ‘idiopathic’ To Diagnosis

In cases of ear congestion of unknown origin it is helpful to assess the function of your internal organs , the overall health of your immune system, if you have any latent infections, if you have markers that indicate a parasite or fungal infection or if you are showing traces of autoimmunity activity.

Often, ear pain or congestion is just one of many symptoms you may experience

These tests should be tailored to your medical situation.

A 65 year old with diabetes, weight gain and a feeling of fullness in her ears will have different tests ordered than a 31 year old with Crohn’s disease whose eustachian tubes have been filled with clear fluid for 2 years.

This functional medicine testing can be done at my clinic, or can be arranged at a hospital near you if you are out-of-state. This testing is usually covered by your insurance.

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How Is A Middle

Your health care provider will take a medical history and do a physicalexam. He or she will look at the outer ear and eardrum with an otoscope.The otoscope is a lighted tool that lets your provider see inside the ear.A pneumatic otoscope blows a puff of air into the ear to check how wellyour eardrum moves. If you eardrum doesnt move well, it may mean you havefluid behind it.

Your provider may also do a test called tympanometry. This test tells howwell the middle ear is working. It can find any changes in pressure in themiddle ear. Your provider may test your hearing with a tuning fork.

What Causes An Ear Infection

Otitis Media

Ear infections are caused by bacteria and viruses. Many times, an ear infection begins after a cold or other respiratory infection. The bacteria or virus travel into the middle ear through the eustachian tube . This tube connects the middle ear to the back of the throat. The bacteria or virus can also cause the eustachian tube to swell. This swelling can cause the tube to become blocked, which keeps normally produced fluids to build up in the middle ear instead of being able to be drained away.

Adding to the problem is that the eustachian tube is shorter and has less of a slope in children than in adults. This physical difference makes these tubes easier to become clogged and more difficult to drain. The trapped fluid can become infected by a virus or bacteria, causing pain.

Medical terminology and related conditions

Because your healthcare provider may use these terms, its important to have a basic understanding of them:

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Balloon Dilation Of Eustachian Tubes

The eustachian tubes that connect the middle ear to the back of the nose are typically closed until you chew, swallow, or yawn. If you try to pop your ears with a yawn, for example, the popping sensation is the opening of the eustachian tubes.If you are regularly unable to pop your own ears when clogged, or if conservative treatment methods like medication dont relieve your chronic ear infection symptoms, you might want to ask Dr. Franklin about balloon dilation of the eustachian tubes.

Also sometimes called a balloon eustachian tuboplasty, this simple and safe procedure can be performed on children as well as adults.

In this minimally invasive procedure, a balloon catheter is inserted through the nostrils into the eustachian tube and inflated to gently dilate the tube, which relieves eardrum pressure and allows fluid to drain from the ear.

The balloon is then deflated and removed. No tissues are cut and nothing remains in the eustachian tube. For these reasons, many patients who experience recurring middle ear infections are beginning to prefer balloon dilation to the more traditional ear tube surgery.

Types Of Ear Infection In Adults

The majority of ear infections are the outer ear infection , but the middle ear infection can also occur .

Outer Ear Infection

Outer ear infections are also known as swimmer’s ear, because it is a common swimmer’s problem. Swimmer’s ear is an infection in the outer canal of the ear. It happens when contaminated water gets into the outer ear letting germs to grow and develop because of the moist, warm conditions.

Middle Ear Infection

Middle ear infection is most often a viral or bacterial infection that affects the air-filled space behind the eardrum, containing small vibrating bones of the ear. When bacteria or fluid gets trapped inside the ear, an infection might occur.

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Symptoms Of A Middle Ear Infection

In most cases, the symptoms of a middle ear infection develop quickly and resolve in a few days. This is known as acute otitis media. The main symptoms include:

  • a lack of energy
  • slight hearing loss – if the middle ear becomes filled with fluid

In some cases, a hole may develop in the eardrum and pus may run out of the ear. The earache, which is caused by the build-up of fluid stretching the eardrum, then resolves.

Rule Out Obvious Causes

Nasal balloon autoinflation safe and effective for chronic ear infections in children

Your first step should be to visit your doctor’s office to rule out physical blockages and acute infection.

If your case is not resolved there, you will be referred to an ear, nose and throat specialist .

Ideally, your ear problem is solved by either of these two visits. If it isn’t, you likely have been told that it may go away on its own and it may not – and there is nothing that you can do but wait.

Fortunately, there are many ways to find out what exactly is causing your chronic ear congestion and – depending on your case – ways to make it go away fast.

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Any Other Recent Innovations In The Treatment Of Ear Infections

Dr. Wang: There’s a procedure I’ve been doing for a few years called Eustachian tube dilation. Using endoscopic guidance through the nose, you insert a balloon in the Eustachian tube, blow it up and leave it there for up to two minutes. This can address the Eustachian tube dysfunction that leads to middle ear infections. I’ve found it works in about 50% of patients, so it doesn’t work for everyone. But it’s so noninvasive, it’s a good place to start with certain patients who are good candidates for it. There’s also a new drug that is almost like a gel that you can squirt into the ear canal. It slowly dissolves and may be easier to get into those really clogged areas than traditional drops.

Chronic Otitis Media Causes

Chronic otitis media often develops from an acute middle ear infection. In other cases, an ear injury or blockage in the Eustachian tubethe structure that connects the back of the nose to the middle earis the cause of chronic otitis media.

Any adult can experience chronic otitis media, although the risk is increased for people who:

  • Smoke or are frequently around smokers
  • Have year-round or seasonal allergies
  • Are regularly exposed to air pollution

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Gut Healing Or Condition Based Diets

A quick note on diets. Diet alone is usually not enough to completely kill off a severe infection despite the claims of gut healing or fungal infection diets.

A good indicator of the efficacy of these diets is to assess how you feel after a cheat meal.

If you have been on a strict diet aimed at killing an infection but when you have one or two cheat meals with refined sugar and your symptoms come back then the infection is still active, it is just being kept at a lower level than before.

Your diet is a fantastic tool for healing quickly but it is one tool of many that we can utilize.

Your diet is an incredibly powerful and necessary tool in your recovery. When used in conjunction with treatment, it is extremely effective.

Before you self-treat with a strict diet, get confirmation testing to determine what is wrong and work with a functional medicine doctor to naturally treat your underlying condition so that your diet can be at its most effective.

Why Do Children Get Many More Ear Infections Than Adults Will My Child Always Get Ear Infections


Children are more likely than adults to get ear infections for these reasons:

  • The eustachian tubes in young children are shorter and more horizontal. This shape encourages fluid to gather behind the eardrum.
  • The immune system of children, which in the bodys infection-fighting system, is still developing.
  • The adenoids in children are relatively larger than they are in adults. The adenoids are the small pads of tissue above the throat and behind the nose and near the eustachian tubes. As they swell to fight infection, they may block the normal ear drainage from the eustachian tube into the throat. This blockage of fluid can lead to a middle ear infection.

Most children stop getting ear infections by age 8.

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Earaches In Adults: What You Need To Know

Been a while since you woke up with a sharp, stabbing earache? Such a distant memory you don’t even know where to find a heating pad like the one your mom used to carefully apply to the side of your face?

Consider yourself lucky but not necessarily off the hook. Although ear infections are more common among children, some 20% occur in adults. Bad news for those of us who thought we had outgrown that phase for good. But the good news is, for the most part, there are easy ways to fix the problem, and even easier ways to avoid the common mistakes that can land even the most responsible adults in the reclining chair of an ear, nose and throat doctor .

Luckily, Dr. Brian Wang, an ENT doctor at Houston Methodist, is here to answer all of our burning questions about the types of ear problems that most frequently occur in adults.

Medical Treatments For Ear Infection In Adults

Medications for Outer Ear Infection

  • Ear drops: Doctors usually recommend ear drops that have a particular combination of the ingredients, such as steroid, antibiotic,antifungal medications or acidic solution, depending on the severity and the type of the infection.
  • OTC pain relievers: Your doctor might also prescribe OTC pain relievers, such as naproxen , Ibuprofen , or Acetaminophen . If you are experiencing severe pain, your doctor may recommend stronger pain reliever.

Medications for Middle Ear Infection

  • Ear drops: Similarly as in the case of the outer ear infections, your doctor may prescribe you some ear drops like Aurodex . They serve as additional pain reliever in case your ear drums are not perforated. Do not use higher dose of benzocaine than the prescribed dose without consulting with your doctor first.
  • OTC pain relievers: Your doctor might recommend pain relievers, such as Ibuprofen or Acetaminophen to ease your pain. Use medications as prescribed by doctor.
  • Surgery: In case the ear infection is not getting cured by usual medications, your doctor might consider ear tubes . During this treatment, a small tube is inserted into the eardrum, leaving a small hole open that lets air to get in, allowing fluid to drain easier. This procedure is done under general anesthesia. If you suffer from enlarged adenoids, your doctor may recommend removing them, especially if they cause ear infections.

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Symptoms Of Chronic Ear Infections

Someone with a chronic ear infection does not usually have any visible symptoms. However, long-term OME can cause hearing problems and other difficulties, particularly in children. These include:

  • delayed responses, or taking a long time to understand speech
  • difficulties speaking or reading
  • less ability to work independently

Doctors consider OME to be chronic if it lasts for or more.

According to a 2016 guideline, OME usually disappears by itself within 3 months.

They also report that 3040 percent of children experience OME more than once, and 510 percent of episodes last for 1 year or longer.

When someone has CSOM, they have a hole in their eardrum. When the eardrum bursts, it releases tension, so not everyone with CSOM will feel . However, people with AOM or recurrent AOM will likely experience pain.

The symptoms of CSOM include:

  • leaking fluid from the ear
  • a hole in the eardrum

People with CSOM are unlikely to have a fever.

Chronic ear infections develop from a long-lasting or recurrent acute ear infection. Preventing acute ear infections can help prevent chronic ear infection.

Acute ear infections happen when the eustachian tube, a tube that runs from the middle ear to the back of the throat, becomes clogged.

Children are more likely to be affected by ear infections because these tubes are shorter and narrower, so they become clogged more easily.

Fluid build-up in the middle ear can become infected, which will cause pain and other symptoms.

Causes of ear infections

Can Adults Still Get Ear Infections

How would you treat recurrent otitis externa in adults?

Ear infections and childhood go hand in hand because kids get them so easily. During the early stages of development, their eustachian tubes the passageway between the nose, throat, and ears are small, short, and parallel to the ground, so they dont drain efficiently.

When mucus builds up because of colds or allergies, bacteria set up shop and infect the tissues.

Adults dont get ear infections as frequently as kids do, but that doesnt mean theyre immune to them. Dr. James Lee at Woodstock Family Practice & Urgent Care in Woodstock, Georgia, helps children and adults deal with ear infections and their underlying causes. Heres what you need to know about adult ear infections.

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What Can Be Done For Recurrent Ear Infections

Sore ears are just sore ears, right? Well, not exactly. Sore ears can be quite mild, but they can also affect you significantly if they are not treated properly. You really do need to avoid recurring ear infections in adults.

An ear infection can either be acute or chronic. Acute infection occurs quickly and usually lasts for a relatively short time. A chronic ear infection, on the other hand, is one that does not get better on its own. The first step to treating these infections is avoidance, so you need to understand what causes recurrent ear infections.

You can develop an infection in any part of your ear: outer, middle and inner.

The outer ear is the first canal of your ear, leading to the eardrum. The middle ear is just inside the eardrum and the inner ear is the site where the delicate workings of the ear are located.

Prevention Of Ear Infection In Adults

Prevention of Outer Ear Infection

  • Do not swim in contaminated water and always use ear plugs while swimming.
  • Make sure your ears are dry and clean. Dry your outer ear only, gently wipe it with a soft fabric. Turn your head to the side and drain the water from your ear canal.
  • Wash your hands every time you touch your ears.
  • Avoid ear irritation. Place cotton balls into your ears when using hair dryer or hair spray.
  • Avoid scratching your ears with nails, cotton swabs, paper clips or hairpins.

Prevention of Middle Ear Infection

  • Quit smoking and secondhand smoking.
  • Treat colds, allergies or sinusitis. Take a decongestant if you have a cold or before an air travel.
  • Do not place any foreign objects in your ears.
  • Wash your hands regularly, do not go out when you are sick and avoid getting germs from others.

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Any Other Words Of Advice For Adults Regarding Ear Infections

Dr. Wang: Do not stick anything in your ears! Also, if you have diabetes, be very careful with ear infections. They might be much more persistent, painful and treatment resistant. If this happens to you, really prioritize getting your blood sugar under control, because that can greatly affect your body’s ability to shake the infection.

Chronic Otitis Media In Adults

Infección crónica del oÃdo medio en niños

Chronic otitis mediaan ongoing infection or inflammation in the middle earcan affect adults as well as children.

Chronic suppurative otitis media, also referred to as chronic otitis media or a chronic middle ear infection, is often associated with young, growing children. However, adults can also develop this condition. Chronic otitis media refers to a middle ear infection that is longstanding or recurs frequently, potentially leading to hearing loss and other serious complications if it is left untreated.

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